Risk Factors for Failure of Initial Intravenous Immunoglobulin Treatment in Kawasaki Disease.
10.3346/jkms.2008.23.4.718
- Author:
Sungho CHA
1
;
Minjeong YOON
;
Yongjoo AHN
;
Miyoung HAN
;
Kyung Lim YOON
Author Information
1. Department of Pediatrics, College of Medicine, Kyunghee University Hospital, Seoul, Korea. sunghocha@khu.ac.kr
- Publication Type:Original Article
- Keywords:
Coronary Aneurysm;
Immunoglobulins, Intravenous;
Mucocutaneous Lymph Node Syndrome;
Treatment Failure
- MeSH:
C-Reactive Protein/analysis;
Child, Preschool;
Female;
Humans;
Immunoglobulins, Intravenous/*therapeutic use;
Infant;
Male;
Mucocutaneous Lymph Node Syndrome/*drug therapy;
Risk Factors;
Treatment Failure
- From:Journal of Korean Medical Science
2008;23(4):718-722
- CountryRepublic of Korea
- Language:English
-
Abstract:
The aims of this study were to determine the occurrence and variables associated with the initial intravenous immunoglobulin (IVIG) treatment failure in Kawasaki disease (KD) and to categorize differences in clinical characteristics between responders and nonresponders to initial IVIG treatment. Patients were classified into two groups. Group A included 33 patients who received a single dose of IVIG treatment and responded. Group B included 18 patients who received more than two doses of IVIG due to failure of the initial treatment. The mean duration of fever after initial treatment in group B was significantly longer than it was in group A. In group B, we found that higher bilirubin, aspartate aminotransferase (AST), polymorphonuclear cells (PMN) (%), and lower platelet values at baseline were independent predictors of persistent or recurrent fever in patients with KD. Coronary artery abnormalities were found in 8 patients (44.4%) in group B and in two patients (6.1%) in group A. We found that abnormal liver function tests and a lower platelet count at baseline were possible predictors of nonresponders to IVIG in patients with KD. There is a need for a prospective study focused on baseline hepatobiliary parameters.
